Provider Demographics
NPI:1902039191
Name:VASQUEZ, CYNTHIA DEANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:DEANN
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3073 S BUCHANAN ST APT A1
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-1518
Mailing Address - Country:US
Mailing Address - Phone:817-629-6759
Mailing Address - Fax:
Practice Address - Street 1:1575 EYE STREET NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20420-1524
Practice Address - Country:US
Practice Address - Phone:202-894-0931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040144591041C0700X
TX316071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical